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   2018| January-March  | Volume 26 | Issue 1  
    Online since March 20, 2018

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Tessier number 30 facial cleft: A rare maxillofacial anomaly
Elif Sari
January-March 2018, 26(1):12-19
Introduction: In number 30 facial cleft patients, the deformities vary in their presentation, ranging from minor clefting of the lower lip (2) to complete clefts of the mandible with absence of the hyoid bone, thyroid cartilage, and manibrium. Materials and Methods: A case of Tessier number 30 facial cleft with only lower lip deformity is reported in this paper. Results: The pathognomonic features of the facial clefts were reviewed in terms of the related literature. Conclusion: We aimed to remind the pathology and review the literature in this report.
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Malignant proliferating trichilemmal tumor: Clinical presentations, treatment, and outcomes
Mustafa Kürşat Evrenos, Zülfikar Ulaş Bali, Peyker Temiz, Aylin Türel Ermertcan, Levent Yoleri
January-March 2018, 26(1):24-28
Background: Malignant proliferating trichilemmal tumor (MPTT) is very rare malignant tumors of hair follicles derived from outer root sheath. This tumor is mostly located on the head and neck of elderly women. Regional or distant metastasis is possible. In this study, we present clinical features and treatment outcomes of cases diagnosed as MPTT. Furthermore, we aimed to emphasize a different clinical form of the tumor that can be misdiagnosed clinically. Patients and Methods: A retrospective evaluation of five cases operated between September 2009 and February 2017 Celal Bayar University Faculty of Medicine, Plastic Reconstructive and Aesthetic Surgery Department at were included in the study. Clinicopathological features of patients, type of surgery, and follow-up information were evaluated. Results: Four patients were female. Average age was 72.2. All of the lesions were located on the head and neck. All patients had a history of rapid growth of lesions. Patients were scanned with computed tomography. There was no metastasis at the time of diagnosis. None of the patients needed adjuvant therapy. Mean follow-up time was 11.8 months. None of the patients developed recurrence or metastasis. Conclusions: These tumors resemble basal cell or squamous cell carcinoma. Rapid progress of benign form of the tumor should address malignant transformation. There is no consensus about adjuvant therapy. Screening for metastasis and close follow-up are mandatory.
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Treatment of crush degloving injury of the hand with totally avulsed thumb
Altug Altinkaya, Anil Demiröz, Hakan Arslan, Müge Anil Küçüksucu
January-March 2018, 26(1):29-31
Avulsion injuries of the upper extremities are challenging injuries for microsurgeons, and almost always crush and degloving components are present. Due to the severe damage to the neurovascular structures, microsurgical treatment options are quite difficult, but technical advances in microsurgery have resulted in increases in the possibilities of success in crush-avulsion type replantation. Good functional outcomes can be obtained with successful replantation in these cases. In this case report, we present a successful replantation of the totally degloved thumb, the result of a crush-avulsion injury caused by silicone molding machine.
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Epidemiologic analysis and evaluation of complications in 1266 cases with maxillofacial trauma
Cenk Demirdover, Alper Geyik, Hasip Samil Yazgan, Fatih Alp Ozturk, Suleyman Cakmak, Haluk Vayvada, Adnan Menderes, Mustafa Yilmaz
January-March 2018, 26(1):6-11
Introduction: Patients with maxillofacial trauma represent a major group of patients in plastic surgery practice. These traumas are often caused by in-car and noncar road accidents and can result in permanent damages. This study aims at providing an epidemiologic analysis of such cases together with their diagnostic procedures, treatment methods, and postoperative complications. Materials and Methods: A total of 1266 maxillofacial trauma cases that were operated on between 2003 and 2017 were studied, and analyzed for fractured bones, etiology, diagnosis and treatment principles, and complications. Results: The major etiologic factor causing maxillofacial trauma in our study is noncar road accidents (25.5%). Mandible fractures were seen to be the most common type of bone fracture (52.2%). Together with physical examination, computerized tomography and orthopantomography are the diagnostic procedures we effectively use in our clinic. Rigid and semi-rigid fixation with plate and screws are the most frequently used treatment methods, and complication rates are seen to be lower (by 6.6%) than those reported in the literature. Conclusion: Careful and meticulous processes, as well as effective follow-up of the patient are required to achieve optimal esthetic and functional results in maxillofacial trauma cases. Such approach can help to reduce the possibility of complications and allow for their early identification, hence early intervention.
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Clear cell acanthoma in an unexpected location
Atilla Adnan Eyuboglu, Arzu Karatas Togral, Eda Yilmaz Akçay, Nilgün Markal Ertas
January-March 2018, 26(1):40-42
Clear cell acanthoma (CCA) is an uncommon, benign, and slow progressing lesion originating from epidermal keratinocytes. Lesions are not gender specific and usually diagnosed at 50–60 years of age. It is generally represented in the lower extremities. CCA was first described by Degos et al. as “Degos acanthoma” for a lesion presented in the lower extremity. Clinically, it is hard to distinguish whether the lesion is benign or malignant. Final diagnosis can be made histopathologically. Biopsy material is periodic acid–Schiff positive. While CAA commonly presents itself in the lower extremities, our patient had a CAA in his abdominal region.
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Our clinical experiences in lower eyelid reconstruction
Zeynep Altuntas, Ilker Uyar, Sidika Findik
January-March 2018, 26(1):2-5
Objective: Different treatment principles have been applied in the reconstruction of partial or full layer defects of the lower eyelid. The use of the most similar tissue for eyelid reconstruction is important for both functional and esthetic results. This study aims to investigate the reconstruction methods performed in lower eyelid defects and to evaluate their esthetic and functional results. Patients and Methods: In this study, patients who underwent reconstructive surgery from 2012 to 2016 in our clinic were investigated. Cases of primary repairs after skin tumors located in the lower eyelids were excluded from the study. The sociodemographic characteristics of patients, the type and location of the tumor, defect size after surgery, anterior and posterior lamellar defects, and reconstruction methods used were retrospectively reviewed. Results: Thirty-seven patients were included in the study. Fifteen were male and 22 were female. There was only anterior lamellar defect in 29 patients and full-thickness lower eyelid defect in 8 patients. Anterior flaps used in lamellar defects were identified as glabellar flap, Limberg flap, advancement, transposition flap, nasolabial flap, forehead flap, and cheek flap. Chondromucosal graft, palatal mucosal graft, and buccal mucosal graft were used for repairing posterior lamellar defects. Conclusion: Separate reconstruction of the posterior and anterior lamellae is important to provide good functional and esthetic results in lower eyelid reconstruction. Depending on the size of the defect, using a single local flap or a combined flap with posterior lamella repair provides highly acceptable results.
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Rhinoplasty in a blind patient
Safvet Ors
January-March 2018, 26(1):32-33
Retinitis pigmentosa is an inherited, degenerative eye disease that causes severe vision impairment due to progressive degeneration of the rod photoreceptor cells in the retina. Nasal deformities are known to attract attention, result in stigmatization, and negatively affect a person's self-perception. Cosmetic surgical management of blind patients is a broad undertaking, requiring the involvement of both a plastic surgeon and a psychologist. While plastic surgeons have performed various reconstructive surgeries on blind patients, including mammoplasty and abdominoplasty, rhinoplasty for a blind patient has not been reported to date. The results of this study point to the positive psychosocial outcomes in a 33-year-old blind patient following rhinoplasty.
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Pediatric upper extremity fence-penetrating traumas
Musa Kemal Keles, Ugur Horoz, Bugçe Ballioglu, Hatice Gözde Muratoglu, Ergin Seven, Ali Teoman Tellioglu
January-March 2018, 26(1):20-23
Purpose: Penetrating hand injuries related to sharp metal or wooden fences are rarely reported in pediatric population. Most of these traumas occur after accidentally falling on the fence. The aim of this study is to evaluate the characteristics of the patients suffering from fence injuries and to present our management. Materials and Methods: In this study, 14 patients admitted to our emergency department with fence postpenetrating traumas between March 2013 and April 2016 were retrospectively examined. Eleven pediatric patients with fence postpenetrating trauma to upper extremity were included. Patient demographics, zone of injury, injury type, surgical intervention, and follow-up results were documented. Statistical analysis was performed using Chi-square test. Results: In the past 4 years, 11 patients aged 4 to 15 years with fence-related upper extremity traumas were treated in our clinic. Preteen age group was the most affected group. The most commonly penetrated region was below the elbow (7 patients). All wounds were surgically explored for accompanying injuries and repaired if any neurovascular or muscle injuries were present. Conclusion: To be able to prevent and appropriately treat these types of injuries in children, it is necessary to surgically explore and understand the mechanism.
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A rare cause of squamous cell carcinoma which develops at an early age: Epidermodysplasia verruciformis
Seyda Guray Evin, Ahmet Bilirer, Osman Akdag, Mehtap Karamese
January-March 2018, 26(1):37-39
Epidermodysplasia verruciformis (EV) (Lewandowsky–Lutz syndrome) is a genodermatosis that accommodates premalignant skin lesions extensively infected with human papillomavirus with underlying cellular and humoral immune disorders. Localized especially in regions extensively exposed to the sun such as the forehead, these skin lesions may turn into malignant lesions with the mutation-inducing effect of ultraviolet lights. The skin lesions that may emerge as a result of this transformation include actinic keratosis, Bowen's disease, squamous cell carcinoma (SCC), and more rarely basal cell carcinoma. The SCC that develops in patients with EV may act aggressively and can become locally invasive. This article aims at presenting the underlying EV as a rare etiological cause in patients with SCC at an early age.
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Stewart–Treves syndrome: A case report and review of literature
Atilla Adnan Eyuboglu, Harun Cologlu, Nebil Bal, Abbas Albayati, Nilgun Markal Ertas
January-March 2018, 26(1):34-36
Stewart–Treves syndrome (STS) is defined as angiosarcoma arising in the setting of chronic lymphedema. It is typically presented in breast cancer patients who underwent axillary dissection. A 79-year-old woman presented to our clinic with a wound that developed secondary to lymphedema. Pathologic examinations diagnosed the lesion as angiosarcoma. STS is a rare and deadly entity. It is hard to diagnose and has 10% mean survival rate for 5 years. We emphasize the importance of early diagnosis that can be a lifesaver.
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Cenk Demirdover
January-March 2018, 26(1):1-1
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